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Disclaimer: This article is for informational purposes only. Please speak with a medical professional before seeking treatment. 

What can creative arts therapies help with?

Treating PTSD, brain injury, and co-occurring diagnoses such as depression and anxiety.

Here I am, a strong, physically demanding warrior. Why do I have to do art? ... Each time I did something with art therapy I felt better because there was something in me that was dying to get out. And through art I was able to express it.

Captain Jason Berner, U.S. Marine Corps

What are creative arts therapies?

Using words to express memories and emotions isn’t always easy, especially after a traumatic event. Creative arts therapies provide healthy, non-threatening ways of processing your experiences and feelings, as well as offer a chance to communicate those feelings to yourself and others. There are several forms of creative arts therapies, each with distinct treatment methods and qualified providers. Art Therapy, Music Therapy, Drama Therapy, and Dance/Movement Therapy are commonly used to promote self-expression.

Each of these therapies do not require prior skill or experience, simply openness to engaging with thoughts and/or honing functional skills in novel, creative ways. When addressing past trauma, these forms of therapy are generally used alongside other treatment methods, such as cognitive processing therapy (CPT) or prolonged exposure therapy (PET).

What should I look for in a provider?

Providers in creative arts therapies should hold national certifications to support rehabilitation or healing through arts-based processes. Each discipline has its own credentialing to ensure skilled care in line with professional standards. These clinicians should also have received specialized education from a university or college that is approved by the field’s accrediting body.

Generally, you should look for the following credentialing by your provider’s names:

  • Art Therapists: ATR or ATR
  • Music Therapists: MT-BC
  • Drama Therapists: RBT
  • Dance/Movement Therapists: R-DMT or BC-DMT

Art Therapists should have a master’s degree or higher, generally from an integrated program in psychotherapy and visual arts. The initials ATR after a therapist’s name means he or she is registered with the Art Therapy Credentials Board (ATCB). The initials ATR-BC means the therapist is not only registered but has passed an examination to become board-certified by the ATCB (Art Therapy, 2021).

Music Therapists must hold a bachelor’s degree or higher in music therapy from an American Music Therapy Association-approved university. The credentials MT-BC (Music Therapist-Board Certified) is necessary for professional practice through the Certification Board of Music Therapists.

Drama Therapists should be certified as Registered Drama Therapists (RDT) following a master’s degree or higher in drama therapy from a North-American Drama Therapy Association or a master’s or higher in theatre or a mental health profession with additional in-depth NADTA training.

Dance/Movement Therapists require a master’s degree from an American Dance Therapy Association Approved Graduate Program or an alternate route with master’s in an associated area with dance/movement training from qualified instructors. This method would award a clinician a Registered Dance/Movement Therapist (R-DMT) credential. A Board Certified Dance/Movement Therapist (BC-DMT) can be obtained after an R-DMT in preparation for ability to train and supervise other therapists or offer private practice, based on additional competence and experience.

What is the treatment like?

Across all disciplines, the first session typically includes a conversation between you and the therapist to develop goals and plan next steps based on your personal needs and preferences. You are then given the tools to create art through whatever medium you prefer and find works well to express. “Once you begin creating, the therapist may, at times, simply observe your process as you work, without interference or judgment (Art Therapy, 2021).” When you are done, the therapist may ask how you feel about the process of creating art or discuss the personal meaning behind the artistic expression.

While recreational arts programs can be beneficial in providing a creative and meaningful leisure outlet, creative arts therapies are formal treatment led by trained therapists (Jones et al., 2017). These providers offer guidance to find and process personal messages in each piece of art you create, while providing constructive feedback (Kaimal & Blank, 2015) and conducting assessments that provide insight into emotional, physical, and cognitive health. These more structured interactions can also help treatment providers stay aware of your clinical progress.

One example of an Art Therapy intervention commonly used in brain injury or PTSD programs is the creation of masks for self-expression. These masks can be used to illustrate fractured identities, such as how you see yourself before and after deployment or injury or the relationship between your “good” and “bad” sides. It can also relate to the injuries themselves, feelings of grief or loss, or anything else that you may want to explore, express, or understand. The mask can also give you a way to express things you hadn’t been able to before, and serve as a starting point for conversations with friends, family members, and people on your treatment team (Jones et al., 2017).

Caption: “An Army flight medic. The mask represents our country shedding tears for our military on one side, and our military shedding tears for our country on the other side. Quotes on the military side (which also symbolizes death via the skull) read, “Shed no more tears, your medic will shed them for you,” and “I have destroyed my life and myself so that others may live.”” Mask by a military service member from art therapy sessions at the National Intrepid Center of Excellence, Walter Reed National Military Medical Center. (National Museum of Health and Medicine photo by Matthew Breitbart/ Released) [or NEA, DoD Launch Creative Forces Sites Expansion to Increase Art Therapies]

It wasn’t long before I drew a picture of my operation. It was horrifically hard, but I wanted to put down in a painting what had happened to me. It let me talk about what had happened, more than I ever could in words.

Chris Miller, a retired teacher who suffered a brain injury after getting a tumor removed

Why does it work?

Using creative arts allows you to draw on a nonverbal or creative communication that can prompt conversations about traumatic memories and confusing emotions. This can lead to more productive dialogues with the people involved with your life and your care. Further, conversations and meaningful processing occurring within therapy sessions can also translate into the development of coping strategies that can be used outside of the art studio, such as more comfortable social interactions, reduced feelings of guilt and loss, and improved self-esteem. Engagement in different mediums of art with the support of your therapist can also facilitate improvements in functional skills through use of your cognitive and physical abilities in a novel environment. For instance, painting offers opportunities for strategic planning, organization, fine and gross motor skills, balance, and hand eye coordination as you put paint brush to canvas.

How strong is the evidence?

Formal research continues in this field, but many studies and individuals have found art therapy to be helpful in promoting growth and recovery after a brain injury or PTSD, often leading to an improved quality of life. In particular, research highlights improved self-awareness, integration and expression of traumatic experiences, improved interpersonal communication, and improved self-regulation, coping, and cognition as commonly seen outcomes linked with this type of therapy.

Practical Exercises

Create art such as drawing, painting, sculpture, writing, singing, or playing music.

Alternative Therapy Expo | Neuro Community Care (neurocc.com)

Foundation for Art and Healing: Creative Exercises

Foundation for Art and Healing: Helping Youth Cope with Tragedy through Creative Expression

What do patients say?

Art touches everyone. It speaks in volumes beyond words. I’ve had veterans who’ve come up to my art and say, ‘This makes me want to talk.’ While others said, ‘Is there art within me? How do I find out?’ And the therapy of it, I can see it in their faces, how essential it was and how it is, how it touched the very core of self-healing.

— Phyllis, a U.S. Navy Veteran (starting around 2:20)

 

All of these songs that I had written are about what it feels like to come home. Each song is like a little demon, a little monster that had been haunting me. These songs are deeply personal; they’re like a singing diary. Songwriting was a way to take something negative and place it somewhere else other than inside myself.

— Jason Moon, Iraq war veteran, singer/songwriter

 

It wasn’t long before I drew a picture of my operation. It was horrifically hard, but I wanted to put down in a painting what had happened to me. It let me talk about what had happened, more than I ever could in words.

— Chris Miller, a retired teacher who suffered a brain injury after getting a tumor removed

 

 

Here I am, a strong, physically demanding warrior. Why do I have to do art? ... Each time I did something with art therapy I felt better because there was something in me that was dying to get out. And through art I was able to express it.

Captain Jason Berner, U.S. Marine Corps

What do experts say?

Art therapy provides a nonverbal opportunity to process things that may be uncomfortable to use words to process.

—  Jackie Biggs, Art Therapist NICoE TBI Clinic Fort Belvoir

 

Having the art is a way to see the future, to see who they are, and to express themselves, is really helpful ... and how people are seeing who they are, compared to how they feel on the inside, compared to the exterior self.

— Daniel Blausey, ATR-BC, LCAT, Art Therapist, Educator, and Artist

 

We see improvement -- that they’re symbolically showing this bright future, perhaps the contrast between how they felt before and how they’re feeling moving forward.

— Melissa Walker, Art Therapist NICoE Walter Reed National Military Medical Center

Personal Stories

  • In this video, US Army Sgt Fox explains how his memorial box has helped him heal and remember meaningful events and people in his life.
    From BrainLine
  • How people at the JFK Rehabilitation Center in Edison, New Jersey are using art to help them recover from traumatic brain injuries.
    From NJTV News.
  • Watch this video from the National Endowment for the Arts (NEA) and DoD to see music (and other arts) therapy helping injured service members.
    From BrainLine
  • Captain Jason Berner, United States Marine Corps, struggled with the contrast of being a strong warrior and learning to express himself creatively.
    From The Foundation for Art and Healing

Research, Articles, and Books

References

Art Therapy. (2021). Psychology Today.

Fiet, L. (2014). Mask-making and Creative Intelligence in Transcultural Education. Caribbean Quarterly, 60(3), 58–72.

Gant, L., & Tripp, T. (2016). The image comes first: Treating preverbal trauma with art therapy. Art Therapy, Trauma, and Neuroscience, 67–99.

Jones, J. P., Walker, M. S., Drass, J. M., & Kaimal, G. (2017). Art therapy interventions for active duty military service members with post-traumatic stress disorder and traumatic brain injury. International Journal of Art Therapy, 23(2), 70–85.

Kaimal, G., & Blank, C. A. L. (2015). Program Evaluation: A Doorway to Research in the Creative Arts Therapies. Art Therapy, 32(2), 89–92.

King, J.L. (Ed.). (2016). Art Therapy, Trauma, and Neuroscience: Theoretical and Practical Perspectives (1st ed.). Routledge.

Kopytin, A., & Lebedev, A. (2013). Humor, Self-Attitude, Emotions, and Cognitions in Group Art Therapy With War Veterans. Art Therapy, 30(1), 20–29.

Sargent, P. D., Campbell, J. S., Richter, K. E., McLay, R. N., & Koffman, R. L. (2013). Integrative Medical Practices for Combat-Related Posttraumatic Stress Disorder. Psychiatric Annals, 43(4), 181–187.

Walker, M. S., Kaimal, G., Gonzaga, A. M. L., Myers-Coffman, K. A., & DeGraba, T. J. (2017). Active-duty military service members’ visual representations of PTSD and TBI in masks. International Journal of Qualitative Studies on Health and Well-Being, 12(1), 1267317.

Disclaimer: This article is for informational purposes only. Please speak with a medical professional before seeking treatment. 

 

Reviewed by Katie Mitchell, MS, CTRS, LRT, Lyndsay Tkach, MA, CBIS, and Michelle Neary, March 2021.

The BrainLine Treatment Hub was created in consultation with TBI and PTSD experts.